大量输血对受血者凝血功能的影响

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摘要目的探讨大量输血对受血者凝血功能的影响。方法回顾性分析2012-01至2015-05首钢医院收治的85例需大量输血患者(≥1200 ml)的临床资料,分别于术前、术后第1 天及第3天对受血者的血细胞计数值(HGB、HCT、PLT等)、血凝指标值(FIB、APTT、PT等)进行测量,观察各数值变化,以分析大量输血对受血者凝血功能的影响。结果与术前相比,术后第1天受血者的PLT值明显降低,且术后第3天仍未恢复术前水平,差异有统计学意义(P＜0.05)。术后第1天,受血者的HCT值、HGB值均显著高于手术前,差异均有统计学意义(P＜0.05),术后第3天受血者的HCT、HGB值较术前水平高。术后第1天,患者的FIB值明显较术前低,差异有统计学意义(P＜0.05);术后第3天,患者的FIB值高于术前水平,差异有统计学意义(P＜0.05)。而术后第1天受血者的PT、TT、APTT均较术前明显延长,差异有统计学意义(P＜0.05)。术后第3天,受血者的PT、TT、APTT值较术后第1天有显著改善,差异有统计学意义(P＜0.05)。结论大量输血后,受血者血小板显著减少,凝血功能大幅度下降,应加强监测,及早发现可能的凝血功能障碍。

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	张颖
	任惠彦
	郑燕蓉

关键词 ：受血者, 凝血功能, 大量输血

Abstract：Objective To study the effects of massive blood transfusion on coagulation function in blood recipients.Methods Clinical data of 85 massive transfusion patients (≥1200 mL) admitted from January 2012 to May 2015 were reviewed retrospectively.Items of blood routine test (HGB, HCT, PLT etc.) and blood coagulation test (HGB, HCT, PLT, etc.) at preoperative time, 1st day and 3rd day of postoperation were measured, collected and analyzed separately.Results Postoperative PLT level significantly decreased,compared with that of pre-operation; and did not restore to preoperative levels even 3 days after operation, the difference was statistically significant (P<0.05). HCT and HGB levels at the 1 st postoperative day were significantly higher than those pre-operation, the difference was statistically significant (P<0.05). HCT and HGB at the 3rd postoperative day were higher than those pre-operation. FIB level at the 1st postoperative day was significantly lower than that pre-operation, the difference was statistically significant (P<0.05). FIB level at the 3rd postoperative day was higher than that pre-operation, the difference was statistically significant (P<0.05). PT, TT, APTT at the 1st postoperative day were longer than those pre-operation, the difference was statistically significant (P<0.05). PT, TT, APTT at the 3rd postoperative day were significantly improved, compared with those at the 1st postoperative day, the difference was statistically significant (P<0.05).Conclusions The platelet level in blood recipient reduces significatly after massive transfusion, and the coagulation function decreases greatly.Coagulation function should be monitored closely to aware the occueernce of its dysfunction.

Key words： blood recipient coagulation function massive transfusion

收稿日期: 2015-10-11

ZTFLH:

R457.1

作者简介: 张颖,本科学历,主管检验技师。

引用本文:

张颖, 任惠彦, 郑燕蓉. 大量输血对受血者凝血功能的影响[J]. 武警医学, 2016, 27(4): 353-355. ZHANG Ying, REN Huiyan, and ZHENG Yanrong. Effects of massive blood transfusion on coagulation function in blood recipients. Med. J. Chin. Peop. Armed Poli. Forc., 2016, 27(4): 353-355.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2016/V27/I4/353

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